Hotmail co-founder Sabeer Bhatia, 53, is pre-diabetic. Jasmeet Jolly, 43, a Delhi-based hospitality business owner, is diabetic. They are among the 537 million adults who are living with diabetes, as per the latest figures from the International Diabetes Federation (IDF). The total number of people living with diabetes is projected to rise to 643 million by 2030 and 783 million by 2045. As we mark World Diabetes Day, India needs to start taking diabetes a lot more seriously: its prevalence has been rising more rapidly in low- and middle-income countries (such as India) than in high-income countries, according to the World Health Organisation.
Diabetes is a chronic disease that occurs when the pancreas is no longer able to make insulin, or when the body cannot make good use of the insulin it produces, says the IDF. Insulin is the hormone that allows the cells in your body to use blood sugar for energy, explains Dr. Sunil Kumar Mishra, senior director for endocrinology and diabetes at the Medanta Hospital, Gurugram. A study by Cambridge University researchers, published earlier this year, found that people with Type 2 diabetes have a higher risk of developing up to 57 other health complications. These include cancer, as well as neurological, digestive and kidney ailments. It also causes a higher risk of mental health problems.
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People with Type 2 diabetes were 5.2 times more likely to have end-stage kidney disease, 4.4 times more likely to get liver cancer and 3.2 times more likely to develop a sight-threatening condition called macular degeneration, found the study, which examined data of 3 million people and 116 illnesses among middle aged people. “There is a definite increase in the risk of heart ailments, brain issues, foot ulcers, kidney problems, nerve issues, and eye problems,” says Mishra.
However, not all news is grim. Apart from medical treatment, it has been found that exercise and weight loss are effective ways of managing diabetes. In a path-breaking study by Professor Roy Taylor of Newcastle University 11 years ago, it was demonstrated that Type 2 diabetes can be reversed through rapid weight loss. “Even before starting medicines for diabetes, exercise is advisable in patients with prediabetes,” says Dr. Chhavi Agrawal, associate consultant for endocrinology at Fortis Escorts Hospital at Okhla, New Delhi.
Both Bhatia and Jolly know this and maintain an active lifestyle as well as keeping their weight under check. Jolly, who has diabetes running in her family, and used to be overweight as a child, runs long distances and does strength training throughout the week. Bhatia plays tennis, cycles long distances, including uphill, and also does intermittent fasting. “Losing weight is the only way to beat diabetes, and intermittent fasting is among the best ways to lose weight,” he says. When you start any form of physical work, your body starts metabolising glucose to meet excessive energy demands which is exactly what we are looking at with those who do not produce enough insulin resulting in elevated blood sugar levels, says Gagan Arora, Delhi-based celebrity trainer and founder of Kosmic Fitness.
“When people exercise, their muscle intake of glucose increases, lowering plasma glucose levels in the blood and thus maintaining blood sugar levels. It is dependent on the type of exercise and muscle group involved in the exercise — all of which contribute to lowering plasma glucose and maintaining optimal blood sugar levels. It is beneficial in all types of diabetes,” says Mishra.
Jolly, who was diagnosed with diabetes two-and-a-half years ago, says her doctor had prescribed her twice daily medication for the rest of her life. But she discussed her diagnosis with her fitness coach, Arora, and her doctor, and tweaked her exercise to include a mix of running and strength training. This has helped keep her blood sugar levels under control, and that has also led to the doctor reducing her diabetes medication to just once a day. “I didn’t want to be dependent on medicine for the rest of my life and my exercise routine has helped me reduce my medication for diabetes,” Jolly says.
Cardio exercises burn the excess glucose in your blood stream and also lead to fat metabolism, says Arora. “Cardio exercises also result in an overall good feeling, better blood flow to all the working muscles, better lung and heart function. Strength training improves the muscle tone and strength and makes them more neurologically active so they are not damaged by the high glucose in the blood. More muscles means your body will burn more calories even at rest. However, this adaptation takes time and consistency,” he adds. “Once I was diagnosed with diabetes, I included strength training in my routine,” says Jolly.
Because diabetes affects the muscular and skeletal system, and thus affects flexibility, people who exercise are able to maintain the integrity of the muscles, limbs, spine, and joints, as well as gain a sense of wellbeing. “We always encourage diabetics to maintain a healthy lifestyle that includes 30-40 minutes of regular exercise,” says Mishra.
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While exercise is extremely beneficial for diabetics, they also need to be careful because just like they can’t let their blood sugar levels spike, they can’t even let the levels sink. If the blood sugar levels plummet, there is the risk of hypoglycemia, says Agrawal. Jolly ensures she eats a snack like banana or dates before workout and hydrates properly with water or BCAA solution while exercising to ensure her blood sugar levels don’t dip dangerously.
Doctors also suggest paying attention to nutrition and diet in order to effectively manage diabetes. “All diabetic should consume low calorie food and food items with low glycemic index,” says Agrawal. While Jolly takes extra care about what she eats and plans her meals and snacks, Bhatia prefers intermittent fasting, which he says is working very well for him.
Shrenik Avlani is a writer and editor and the co-author of The Shivfit Way, a book on functional fitness.